Comparing impact on the family and insurance coverage in children with cerebral palsy and children with another special healthcare need

Schaible, Braydon; Colquitt, Gavin T.; Caciula, Manuela C.; Carnes, Alexis; Li, Li; Moreau, Noelle G.

doi:10.1111/cch.12547

Cited by 14 publications

(18 citation statements)

References 27 publications

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“…Cerebral palsy is characterized by movement and posture abnormalities accompanied by secondary complications such as joint contracture and postural deformity [13] and requires various treatments over an extended period of time. A higher occurrence of unmet health care needs among children with special health care needs including CP has been identified in various studies [7][8][9][10][11]. We thought that understanding the state of care provided to children with CP would be the basis for solving unmet health care needs.…”

Section: Discussionmentioning

confidence: 95%

“…A higher occurrence of unmet health care needs among children with special health care needs has been identified in various studies. Using the 2007 National Survey of Children's Health, the authors found that about 4% of US children have unmet medical care needs [7,8]. McManus et al reported that children who need special health care needs have an unmet rehabilitation need and there was a difference in the therapeutic use according to severity of developmental condition [9,10].…”

Section: Introductionmentioning

confidence: 99%

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The nature of rehabilitation services provided to children with cerebral palsy: a population-based nationwide study

Kim

Jeon

Youk

et al. 2019

BMC Health Serv Res

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Background: Cerebral palsy (CP) is a serious neurodevelopmental disorder that occurs in childhood and requires a range of treatments over a person's lifetime. The aims of this study were to investigate the nature of the rehabilitation treatments provided to children with CP and to determine if there were any changes in patterns over time. Methods: From 2003 to 2013, the nature of rehabilitation treatment was analyzed for children diagnosed with CP. In addition, the medical data of rehabilitation treatments over a 10-year period (from birth to nine years of age) were analyzed for children born in 2004 diagnosed with CP. Furthermore, we analyzed whether there was a difference in the costs of medical expenditures according to family income. All studies were based on data from the Korean National Health Information Database. Results: It was found that, in recent years, rehabilitation therapy and spasticity treatment of children with CP have started being performed at a younger age than in the past. Among the children with CP born in 2004, 28.6% had physical therapy and 25.4% had occupational therapy on an inpatient basis; 81.3% had physical therapy and 62.2% had occupational therapy on an outpatient basis. Additionally, 22.2% of children received botulinum toxin injection therapy at least once. The numbers of children receiving rehabilitation therapy and botulinum toxin injection were highest at 1-5 years of age and 6-7 years of age, respectively. The expenditure on rehabilitation therapy was not affected by the economic level of the family. Conclusion: This study investigated the nature of rehabilitation services provided to children with CP. More recently, the treatment of children with CP has started to be performed earlier than in the past. In addition, it was confirmed that the nature of rehabilitation treatment for children with CP changed according to age. Based on these results, services and health policies may need to be better organized to enhance the benefits to children with CP.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The nature of rehabilitation services provided to children with cerebral palsy: a population-based nationwide study

Kim

Jeon

Youk

et al. 2019

BMC Health Serv Res

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“…In turn, a child' s health care cost may exacerbate a family' s financial strain and hinder caregiver employment opportunities, a key driver toward housing insecurity. [30][31][32][33] This was a single-state observational study in which we evaluated only select Medicaid plans within a CM population, which limits its generalizability. However, we were able to examine health plan rather than singleinstitution usage data.…”

Section: Discussionmentioning

confidence: 99%

Social Determinants of Health and Emergency and Hospital Use by Children With Chronic Disease

Foster¹,

Simon

Qu³

et al. 2020

Hospital Pediatrics

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To evaluate the association between caregiver-reported social determinants of health (SDOH) and emergency department (ED) visits and hospitalizations by children with chronic disease.METHODS: This was a nested retrospective cohort study (December 2015 to May 2017) of children (0-18 years) receiving Supplemental Security Income and Medicaid enrolled in a case management program. Caregiver assessments were coded for 4 SDOH: food insecurity, housing insecurity, caregiver health concerns, and safety concerns. Multivariable hurdle Poisson regression was used to assess the association between SDOH with ED and hospital use for 1 year, adjusting for age, sex, and race and ethnicity. ED use was also adjusted for medical complexity.RESULTS: A total of 226 children were included. Patients were 9.1 years old (SD: 4.9), 60% male, and 30% Hispanic. At least 1 SDOH was reported by 59% of caregivers, including food insecurity (37%), housing insecurity (23%), caregiver health concerns (18%), and safety concerns (11%). Half of patients had an ED visit (55%) (mean: 1.5 per year [SD: 2.4]), and 20% were hospitalized (mean: 0.4 per year [SD: 1.1]). Previously unaddressed food insecurity was associated with increased ED use in the subsequent year (odds ratio: 3.43 [1.17-10.05]). Among those who had $1 ED visit, the annualized ED rate was higher in patients with a previously unaddressed housing insecurity (rate ratio: 1.55 [1.14-2.09]) or a safety concern (rate ratio: 2.04 [1.41-2.96]). CONCLUSIONS:Over half of caregivers of children with chronic disease enrolled in a case management program reported an SDOH insecurity or concern. Patients with previously unaddressed food insecurity had higher ED rates but not hospitalization rates.

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“…Of the 28 studies covered by the 30 included articles, 9 were conducted in the United States, [17][18][19][20][21][22][23][24][25] with a tenth cross-national…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…46 All included studies were observational, but used various data collection modes and recall periods. Sixteen used a cross-sectional study design, [18][19][20][21][22][25][26][27][28][29][30]36,39,42,43,46 collecting data with paperpencil questionnaires or phone-administered surveys [18][19][20][21][22]25,[27][28][29]36,39,42,43,46 or combining face-to-face interviews with a self-report questionnaire. 26,30 Of these 16, 7 studies assessed expenses retrospectively, with a recall period of 12 months.…”

Section: Out-of-pocket Medical Expenses Out-of-pocket Nonmedical Expensesmentioning

confidence: 99%

Measuring Financial Burden in Families of Children Living With Life-Limiting Conditions: A Scoping Review of Cost Indicators and Outcome Measures

et al. 2021

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This study aimed to provide a comprehensive overview of cost indicators and outcome measures used to measure financial burden in families of children with life-limiting conditions.Methods: A scoping review methodology was used to map the existing literature and provide an overview of available cost indicators and outcome measures. Key medical, economic, and scientific databases were systematically searched to identify relevant articles published in 2000 or later.Results: The database search yielded 7194 records, including 30 articles eligible for final inclusion. Retrieved cost indicators and outcome measures fell into 3 broad categories: direct costs, indirect costs, and financial support. No study comprehensively assessed all 3 categories. Cost indicators used to measure direct costs were grouped into 5 medical and 11 nonmedical out-of-pocket expenses categories, of which 5 were commonly assessed (ie, treatment and diagnostics, travel and transport, accommodation, food, childcare and home help). Half of the reviewed studies included assessments of indirect costs, most commonly estimating work-related income loss by evaluating employment disruptions. Assessments of opportunity costs arising from informal caregiving and of financial support were rarely included.Conclusions: Current estimates of the financial burden faced by families of children with life-limiting conditions are inconsistent and often incomplete, likely resulting in severe underestimations of the costs these families incur. We hope that the framework presented in this article will contribute to a more comprehensive assessment of illness-related financial burden and help guide future policies in this area.

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Comparing impact on the family and insurance coverage in children with cerebral palsy and children with another special healthcare need

Abstract: There is limited evidence highlighting differences between the impact of caring for a child with CP and caring for other CSHCN. Caring for a child with CP has a significant impact on the family, despite insurance coverage.

Cited by 14 publications

References 27 publications

The nature of rehabilitation services provided to children with cerebral palsy: a population-based nationwide study

The nature of rehabilitation services provided to children with cerebral palsy: a population-based nationwide study

Social Determinants of Health and Emergency and Hospital Use by Children With Chronic Disease

Measuring Financial Burden in Families of Children Living With Life-Limiting Conditions: A Scoping Review of Cost Indicators and Outcome Measures

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